Port Huron Neurologic Associates P.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

5101011111 Issued in MI

Legal business name

PORT HURON NEUROLOGIC ASSOCIATES P.C.

Practice address

3825 24TH Ave
Fort Gratiot, MI 48059-4100

Phone

(810) 982-0100

Fax

(810) 982-0365

NPI assigned

Mar 19, 2008

Last updated

Oct 29, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard Ralph Kovar, D.O.NPI 1235147844

Title

President

Phone

(810) 982-0100

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard R Kovar, DO

  • Neurology Physician
  • Fort Gratiot, MI
  • NPI 1235147844
  Medicare reassignment Care Compare group Authorized official
• Adrian Lahr, P.T.

  • Physical Therapist
  • Chesterfield, MI
  • NPI 1891099131
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1699946459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594100",
            "telephone_number": "810-982-0100",
            "fax_number": "810-982-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594100",
            "telephone_number": "810-982-0100",
            "fax_number": "810-982-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT HURON NEUROLOGIC ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "KOVAR",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-982-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "5101011111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3072470-11",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5740293",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Placed on Purpose
• Randy John Plonka, MD
• Holly Plumb
• Elizabeth Anne Poppe
• Port Huron Mercy Family Care Inc
• Port Huron Opco LLC (Medilodge of Port Huron)
• Port Huron Physicians Medical Group PC (Lake Huron Medical Group)
• Port Huron Physicians Medical Group PC
• Kaylee Rae Porter-Stover
• Skylar Kathleen Potter

• Neurology Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.